Physical examination maneuver
Physical Exam
Monofilament Testing
also known as Semmes-Weinstein monofilament test
🎬
Video coming September 2026
How to Perform
Show the patient what the monofilament feels like on an area of normal sensation. Then, with the patient’s eyes closed, apply a 10-g monofilament perpendicular to the skin, beginning at four standard sites on each foot: the plantar surface of the distal great toe and the plantar surfaces of the first, third, and fifth metatarsal heads. Press until the filament buckles, hold it in place for 1–2 seconds, and then release without sliding it across the skin. Ask the patient to report each time they feel the pressure and where they feel it. Avoid callused skin, scars, ulcers, and other areas of disrupted tissue, and vary the sequence and timing of applications. Additional sites may be tested as needed.
How to Interpret
Showing 3 of 4 findings
Carpal Tunnel Syndrome
Diminished monofilament sensation in the hand
Rule in
Minimally helpful
Rule out
Minimally helpful
Evidence:Limited
Diabetic Foot Ulcer
Insensate to the 5.07 (10-g) monofilament, predicting foot ulceration
Rule in
Not helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Limited
Peripheral Neuropathy
Abnormal 10-g (5.07) monofilament sensation
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Strong